An opiate is a natural procuct of the opium poppy and includes heroin and many prexcription medications such as Oxycontin, Percocet, Vicodin, etc. They are usualy rather short acting. An Opioid is a synthetic or man-made opiate and includes medications such as methadone, buprenorphine (Suboxone, Subutex), tramadol (Ultram), Talwin, Nubain, etc. They are usually longer acting.
Withdrawal or the abstinence syndrome is usually short, 3-5 days with the short acting opiates. It is usually longer with the longeracting opioids.
Opiates are agoinsts in that they produce euphoria. Opioids may be agonists, mixed agonist antagoinsts, or partial agonists. They can cause euphoria, dysphoria or both. they are usually used for maintenance.
Narcotic antagoinsts, naloxone (Narcan) the antidote for an opiate overdose, nalmefene (Revex), The narcotic antagonist naltrexone, (Revia, Vivitrol or naltrexone pellets) cause no euphoria or dysphoria are used for maintenance therapy in patients with the disease of addiction and as anticraving medications. They do not produce a withdrawal or abstinence synderome. They can precipitate withdrawal in the opiate or opioid dependent patient.
Detoxification from short acting opiates involves a brief period of maintenance therapy on an opioid, buprenorphine, a partial agonist, to decrease the severity of withdrawal. This is followed by a brief period of no opiates or opioids. Patients receive symptomatic therapy during this short period of time. An antagonist is then administered and continued while the patient builds a foundation in Twelve Step recovery.
Detoxification from longer acting opiates may involve a prolonged period of time on buprenorphine (Suboxone or Subutex) This is followed by a longer period of no opiates or opioids. Patients receive symptomatic therapy during this period of time. An antagonist is then administered and continued while the patient builds a foundation in Twelve Step recovery.
